Systems and methods for a health care E-commerce marketplace

A method of automatically generating and sending a health care claim via a computing system, the method comprising:

• providing, for a health care consumer, remote access to the computing system over a network via a consumer computing device communicably coupled to the network, wherein the computing system comprises a logic subsystem, the logic subsystem storing machine readable instructions executable by the computing system;
• providing, for a provider, remote access to the computing system over the network via a provider computing device communicably coupled to the network;
• providing, for a health insurance administrator, remote access to the computing system over the network via an administrator computing device communicably coupled to the network;
• and
• executing the machine readable instructions at the computing system to:
• display, on the consumer computing device, a health care storefront comprising a search tool;
• receive a query from the health care consumer via the search tool;
• responsive to receiving the query from the health care consumer:
• retrieve, from a database, a list of responses comprising one or more health care providers, each of the one or more health care providers offering a provider bundle comprising one or more health care services at a provider-supplied price;
• for each response, generate a health care service bundle indicator representing the provider bundle;
• filter the list of responses based on a geographic location included in the query;
• calculate an out-of-pocket cost for each response within the filtered list of responses based on a health care plan of the health care consumer and the provider-supplied price;
• and
• display, on the consumer computing device, the filtered list of responses with the health care service bundle indicator for each response and the out-of-pocket cost for each response;
• receive a single order placed by the health care consumer via the consumer computing device for a response selected from the filtered list of responses, the selected response comprising a particular provider bundle to be purchased;
• receive, via the consumer computing device, a prepayment from the health care consumer for the single order, wherein the prepayment is received prior to the health care consumer receiving a corresponding service from the provider, wherein the provider is associated with the particular provider bundle, and wherein the prepayment equals the out-of-pocket cost for the selected response;
• automatically send a notification of the prepayment to the provider at the provider computing device;
• and
• responsive to receiving an order fulfillment notification from the provider via the provider computing device, wherein the order fulfillment notification indicates that the service has been provided to the health care consumer,
• automatically provide the prepayment to the provider at the provider computing device;
• automatically generate the health care claim based on the provided service, the health care consumer, the provider, and a provider network of the provider;
• and
• automatically send the health care claim to the health insurance administrator at the administrator computing device.

A computing system for generating and sending a health care claim, the computing system comprising:

• one or more databases;
• a network, wherein the network communicably couples a consumer computing device, a provider computing device, and a plan administrator computing device to the computing system;
• a processor;
• and
• memory storing processor-executable instructions that cause the processor to:
• responsive to receiving a query from the consumer computing device:
• retrieve, from the one or more databases, a list of responses comprising one or more health care providers offering one or more health care services at a provider-supplied price, the provider-supplied price being supplied as a fee schedule in any one of a plurality of fee schedule formats;
• for each response in the list of responses, automatically process the fee schedule to extract the provider-supplied price;
• filter the list of responses based on a geographic location included in the query;
• calculate an out-of-pocket cost for each response within the filtered list of responses based on a consumer health care plan and the provider-supplied price;
• and
• display, on the consumer computing device, the filtered list of responses with the out-of-pocket cost for each response;
• receive an order from the consumer computing device for a response selected from the filtered list of responses, wherein the selected response is associated with a service;
• receive a prepayment from the consumer computing device for the order, wherein the prepayment is received prior to the service being provided and wherein the prepayment equals the out-of-pocket cost for the selected response;
• place the prepayment into escrow;
• automatically send a notification of the prepayment to the provider computing device;
• and
• responsive to receiving an order fulfillment notification from the provider computing device, wherein the order fulfillment notification indicates that the service has been provided,
• automatically transfer the prepayment from escrow to the provider computing device;
• automatically generate the health care claim based on the provided service, consumer information from the consumer computing device, and provider information from the provider computing device;
• automatically send the health care claim to the plan administrator computing device;
• and
• automatically send receipt documentation based on the health care claim to the consumer computing device, a format of the receipt documentation being different from a format of the health care claim.